Provider First Line Business Practice Location Address:
94-229 WAIPAHU DEPOT ST
Provider Second Line Business Practice Location Address:
SUITE 308F
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-3031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-671-8887
Provider Business Practice Location Address Fax Number:
808-671-8881
Provider Enumeration Date:
11/09/2006